First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Department of Internal Medicine, Japan Labour Health and Welfare Organization Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan.
J Diabetes Investig. 2018 Mar;9(2):360-365. doi: 10.1111/jdi.12739. Epub 2017 Oct 3.
Anagliptin (ANA) improves dyslipidemia in addition to blood glucose levels. However, there are no comparative studies on the effects of ANA and other dipeptidyl peptidase-4 inhibitors on serum lipid profile. We compared the effects of ANA on serum lipid profile with those of alogliptin (ALO) in type 2 diabetes mellitus outpatients.
The study participants were 87 type 2 diabetes mellitus patients who had been treated with dipeptidyl peptidase-4 inhibitors for ≥8 weeks and had a low-density lipoprotein cholesterol (LDL-C) level of ≥120 mg/dL. Participants were switched to either 200 mg/day ANA or 25 mg/day ALO for 24 weeks.
There was no significant difference in percentage change in LDL-C level at 24 weeks between the ANA and ALO groups. Treatment with ANA for 12 weeks significantly decreased LDL-C levels, one of the secondary end-points. Treatment with ANA for 24 weeks significantly improved apolipoprotein B-100 levels, and the percentage change in LDL-C levels at 24 weeks correlated significantly with the percentage change in apolipoprotein B-100 levels in the ANA group.
The LDL-C-lowering effects of ANA and ALO at 24 weeks were almost similar in patients with type 2 diabetes mellitus. However, the results showed a tendency for a decrease in LDL-C level at 24 weeks in the ANA group, and that such improvement was mediated, at least in part, through the suppression of apolipoprotein B-100 synthesis.
阿那格列汀（ANA）除了能改善血糖水平外，还能改善血脂异常。然而，目前尚无关于 ANA 和其他二肽基肽酶-4 抑制剂对血脂谱影响的比较研究。我们比较了阿那格列汀（ANA）和阿格列汀（ALO）对 2 型糖尿病门诊患者血脂谱的影响。
本研究纳入了 87 例接受二肽基肽酶-4 抑制剂治疗≥8 周且低密度脂蛋白胆固醇（LDL-C）水平≥120 mg/dL 的 2 型糖尿病患者。患者被转换为每日 200 mg ANA 或每日 25 mg ALO 治疗 24 周。
24 周时，ANA 和 ALO 组 LDL-C 水平的百分比变化无显著差异。ANA 治疗 12 周可显著降低 LDL-C 水平，这是次要终点之一。ANA 治疗 24 周可显著改善载脂蛋白 B-100 水平，24 周时 LDL-C 水平的百分比变化与 ANA 组载脂蛋白 B-100 水平的百分比变化显著相关。
在 2 型糖尿病患者中，ANA 和 ALO 在 24 周时的 LDL-C 降低作用几乎相似。然而，结果显示 ANA 组 24 周时 LDL-C 水平呈下降趋势，这种改善至少部分是通过抑制载脂蛋白 B-100 合成介导的。
